Bunion

What is Bunion

Bunion is a bump on the base of the big toe that forms when the bones of the big toe joint move out of position.

Bunions may be small at first, but they often get larger over time. The can make walking painful.

What are the causes of Bunion?

A bunion may be caused by:

  • Wearing narrow or pointed shoes that force the big toe to press against the other toes.
  • Abnormal foot development that causes the foot to roll inward (pronate).
  • Changes in the foot that are caused by certain diseases, such as rheumatoid arthritis and polio.
  • A foot injury.

What increases the risk?

The following factors may make you more likely to develop this condition:

  • Wearing shoes that squeeze the toes together.
  • Having certain diseases, such as:
    • Rheumatoid arthritis.
    • Polio.
    • Cerebral palsy.
  • Having family members who have bunions.
  • Being born with a foot deformity, such as flat feet or low arches.
  • Doing activities that put a lot of pressure on the feet, such as ballet dancing.

What are the signs or symptoms?

The main symptom of a bunion is a noticeable bump on the big toe. Other symptoms may include:

  • Pain.
  • Swelling around the big toe.
  • Redness and inflammation.
  • Thick or hardened skin on the big toe or between the toes.
  • Stiffness or loss of motion in the big toe.
  • Trouble with walking.

How is this diagnosed?

A bunion may be diagnosed based on your symptoms, medical history, and activities. You may have tests, such as:

  • X-rays. These allow your health care provider to check the position of the bones in your foot and look for damage to your joint. They also help your health care provider to determine the severity of your bunion and the best way to treat it.
  • Joint aspiration. In this test, a sample of fluid is removed from the toe joint. This test, which may be done if you are in a lot of pain, helps to rule out diseases that cause painful swelling of the joints, such as arthritis.

How is this treated?

There is no cure for a bunion, but treatment can help to prevent a bunion from getting worse. Treatment depends on the severity of your symptoms. Your health care provider may recommend:

  • Wearing shoes that have a wide toe box.
  • Using bunion pads to cushion the affected area.
  • Taping your toes together to keep them in a normal position.
  • Placing a device inside your shoe (orthotics) to help reduce pressure on your toe joint.
  • Taking medicine to ease pain, inflammation, and swelling.
  • Applying heat or ice to the affected area.
  • Doing stretching exercises.
  • Surgery to remove scar tissue and move the toes back into their normal position. This treatment is rare.

Follow these instructions at home:

  • Support your toe joint with proper footwear, shoe padding, or taping as told by your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If directed, apply ice to the injured area:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times per day.
  • If directed, apply heat to the affected area before you exercise. Use the heat source that your health care provider recommends, such as a moist heat pack or a heating pad.
    • Place a towel between your skin and the heat source.
    • Leave the heat on for 20–30 minutes.
    • Remove the heat if your skin turns bright red. This is especially important if you are unable to feel pain, heat, or cold. You may have a greater risk of getting burned.
  • Do exercises as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider.

Contact a health care provider if:

  • Your symptoms get worse.
  • Your symptoms do not improve in 2 weeks.

Get help right away if:

  • You have severe pain and trouble with walking.

Bunion Surgery

Bunion surgery is done to remove a bunion, which is a bony bump on the big toe joint, on the inner side of the foot. A bunion can develop over time when pressure turns the big toe and joint toward the other toes. Bunions may be caused by wearing shoes that are too tight or narrow. They can also be caused by conditions such as rheumatoid arthritis and flat feet.

You may need bunion surgery if your bunion is very large or painful or it affects your ability to walk.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any blood disorders you have.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding or blood clots.
  • Allergic reactions to medicines.
  • Nerve damage.
  • Pain.
  • Numbness, stiffness, or arthritis in the toe.
  • Return of the bunion.
  • Failure of the bone to heal completely after surgery.
  • Failure of the surgery to relieve symptoms.

What happens before the procedure?

General instructions

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do not take these medicines unless your health care provider tells you to take them.
    • Taking over-the-counter medicines, vitamins, herbs, and supplements.
  • Do notdrink alcohol before the procedure as told by your health care provider.
  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
  • Plan to have someone take you home from the hospital or clinic.
  • Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
  • Ask your health care provider how your surgical site will be marked or identified.

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

  • Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

  • 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
  • 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
  • 6 hours before the procedure – stop drinking milk or drinks that contain milk.
  • 2 hours before the procedure – stop drinking clear liquids.

What happens during the procedure?

  • To lower your risk of infection:
    • Your health care team will wash or sanitize their hands.
    • Your skin will be washed with soap.
  • An IV will be inserted into one of your veins.
  • You will be given one of the following:
    • A medicine to numb the area (local anesthetic).
    • A medicine to make you fall asleep (general anesthetic).
  • An incision will be made over the bump at the big toe joint. Depending on the type of procedure that is needed for your bunion, your surgeon may do one or more of the following:
    • Remove the bunion (exostectomy).
    • Cut or replace the damaged joint in your big toe (osteotomy).
    • Use screws or other hardware to keep your foot in the correct position (arthrodesis).
    • Tighten or loosen tissues around the big toe to reposition the toe.
  • The incision will be closed with stitches (sutures) and covered with adhesive strips or another type of bandage (dressing).
  • A supportive device, such as a cast that you can walk on (boot), may be placed on your foot.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
  • Do not drive for 24 hours if you were given a sedative during your procedure.
  • Ask your health care provider when it is safe to drive if you have a boot or other supportive device on your foot.
  • You may be given instructions about how much body weight you can or cannot support on your foot (weight-bearing restrictions). You may be given crutches, a cane, or a walker to help you move around so that you do not put (bear) weight on your foot.

Summary

  • Bunion surgery is done to remove a bunion, which is a bony bump on the big toe joint, on the inner side of the foot.
  • You may need bunion surgery if your bunion is very large or painful or it affects your ability to walk.
  • Before the procedure, follow instructions from your health care provider about eating and drinking, and ask about changing or stopping your regular medicines.

Bunion Surgery, Care After

What can I expect after the procedure?

After the procedure, it is common to have:

  • Pain.
  • Swelling.
  • A small amount of fluid coming from your incision.

Follow these instructions at home:

If you have a post-operative brace, boot, or shoe:

  • Wear the post-op (post-operative) brace, boot, or shoe as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the brace, boot, or shoe if your toes tingle, become numb, or turn cold and blue.
  • Keep the brace, boot, or shoe clean and dry.

If you have a cast:

  • Do notstick anything inside the cast to scratch your skin. Doing that increases your risk of infection. 
  • Check the skin around the cast every day. Tell your health care provider about any concerns.
  • You may put lotion on dry skin around the edges of the cast. Do notput lotion on the skin underneath the cast.
  • Keep the cast clean and dry.

Bathing

  • Do nottake baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers.
  • If your brace, boot, shoe, or cast is not waterproof:
    • Do notlet it get wet.
    • Cover it with a watertight covering when you take a bath or a shower.
  • Keep your bandage (dressing) dry until your health care provider says it can be removed.

Incision care

  • The dressing holds your toe in the correct position. Do not change the dressing until your health care provider approves.
  • Follow instructions from your health care provider about how to take care of your incision. Make sure you:
    • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
    • Change your dressing as told by your health care provider.
    • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.

Check your incision area every day for signs of infection. Check for:

  • More redness, swelling, or pain.
  • Blood or more fluid.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

  • If directed, put ice on the affected area.
    • If you have a removable brace, boot, or shoe, remove it as told by your health care provider.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag or between your cast and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.
  • Move your toes often to avoid stiffness and to lessen swelling.

Raise (elevate) your foot above the level of your heart while you are sitting or lying down.

Driving

  • Do notdrive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
  • Do notdrive or use heavy machinery while taking prescription pain medicine.
  • Ask your health care provider when it is safe to drive if you have a brace, boot, shoe, or cast on your foot.

Activity

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • If physical therapy was prescribed, do exercises as told by your health care provider.

Safety

  • Do notuse the affected leg to support (bear) your body weight until your health care provider says that you can. Follow weight-bearing restrictions as told. Use crutches, a cane, or a walker as told by your health care provider.

General instructions

  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
    • Drink enough fluid to keep your urine pale yellow.
    • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
    • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
    • Take an over-the-counter or prescription medicine for constipation.
  • Do notwear high heels or tight-fitting shoes, even after you heal.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have more redness, swelling, or pain around your incision.
  • You have more fluid or blood coming from the incision.
  • Your incision feels warm to the touch.
  • There is pus or a bad smell coming from your incision.
  • You have a fever or chills.
  • Your dressing gets wet or it falls off.
  • You have swelling in your lower leg.
  • You have numbness or stiffness in your toes.

Get help right away if:

  • You have a rash.
  • You have difficulty breathing.

Summary

  • Do notuse the affected leg to support (bear) your body weight until your health care provider says that you can. Follow weight-bearing restrictions as told. Use crutches, a cane, or a walker as told by your health care provider.
  • If directed, put ice on the affected area. Leave the ice on for 20 minutes, 2–3 times a day.
  • Do not drive or use heavy machinery while taking prescription pain medicine.
15585

Sign up to receive the trending updates and tons of Health Tips

Join SeekhealthZ and never miss the latest health information

15856